Healthcare Reform - Rep. Anh "Joseph" Cao, Republican Vote for Bill

Healthcare reform just passed in the House of Representatives over the weekend. It was expected that most Democrats would vote for it, and that virtually all Republicans would oppose it. That prediction turned out to be mostly accurate, but the biggest surprise of the night was the one Republican who crossed party lines to vote in favor of the healthcare reform bill. Louisiana Representative Anh "Joseph" Cao's vote was largely up for grabs. While the first-term legislator has been relatively nondescript and has voted with the rest of his party on most other issues, his district is heavily Democratic. Cynics would paint his support for health insurance plan reform as an attempt to increase his chances of re-election; however, Cao claims that it was the best choice for his poor constituents, a large population of which are uninsured. He has also pushed for greater funding of hospitals, as well as the ongoing Hurricane Katrina recovery efforts.

The bill probably wouldn't have passed without Cao's vote, since the Democrats barely reached the needed 218 votes to pass the historic reform. It didn't help that 39 Democrats defied Speaker Nancy Pelosi to oppose healthcare reform. He also gives the proposals a veneer of bipartisanship. Although Cao waited until the bill had already passed to cast his votes, Minority Whip Eric Cantor's efforts to steer Cao back into line failed.

So how did this key vote come to be? Cao jumped on board at the last minute, after the House agreed to add an amendment that strengthened the healthcare reform proposal's ban on funding abortion. The original language prevented health insurance subsidies (used by lower-income individuals and families to buy plans on the exchange market that will be established) from being specifically used to pay for abortion services. That provision wasn't strong enough for some pro-life Democrats like Bart Stupak, who wanted to amend the bill. House leaders did not want their amendment to reach the floor, but anti-abortion Cao helped spark the compromise yesterday by calling the White House himself and pledging his support for reform if it was included. After some wrangling, their amendment passed by 240 to 194. The version of the bill that was passed forbids people from using government subsidies to buy any health insurance plan that includes abortion coverage, except for when there is rape, incest, or danger to the mother's life. The addition of the amendment allowed the devout Jesuit to vote "yes".

Cao's vote in favor of healthcare reform may have torpedoed his political aspirations. He has alienated Republicans nationwide by bucking the trend of rejecting the bill. On the other hand, his views in general are unlikely to appeal to voters in a district where Obama received three-quarters of the vote in last year's presidential election--a larger percentage of Democratic party is pro-choice, and many are unhappy with the bill despite being in favor of universal health care. He is unlikely to receive much financial banking from either national party or their bases, although Republicans are chalking his shocking vote up to his being from a "tough district" with a larger than normal percentage of people without a health insurance plan. Cao's victory was largely a fluke; he won a hurricane-delayed election in December against an opponent infamously charged with hiding cash in his freezer (Democrat William Jefferson). Still, it's nice to see a politician following his conscience.

Now, the healthcare reform bill will move on to the Senate. The future of the ban on abortion coverage in the public option (as well as subsidized private health insurance plans) that swayed Cao is unclear. Both sides are gearing up for a heavy debate over the issue. Will Cao regret his vote if the Senate ends up weakening the restrictions?